Prevalence of hip dislocation among children with cerebral palsy in regions with and without a surveillance programme: a cross sectional study in Sweden and Norway

<p>Abstract</p> <p>Background</p> <p>Hip dislocation is a serious complication among children with cerebral palsy (CP). The aim of this study was to compare the prevalence of hip dislocation among children with CP in an area providing regular care with an area providing hip surveillance services.</p> <p>Methods</p> <p>This is a cross-sectional study in seven Norwegian counties providing regular care and one Swedish healthcare region where a hip surveillance programme was introduced in 1994. Data were provided by the Norwegian Cerebral Palsy Register and the CP Register in Southern Sweden. Children born 1996 - 2003 with moderate to severe CP, defined as Gross Motor Classification System (GMFCS) levels III - V, were included. In all, 119 Norwegian and 136 Swedish children fulfilled the criteria. In Norway, data on hip operations and radiographs of the hips were collected from medical records, while these data are collected routinely in the Swedish register. The hip migration percentage was measured on the recent radiographs. Hip dislocation was defined as a migration percent of 100%.</p> <p>Results</p> <p>The proportion of children at GMFCS levels III - V was 34% in the Norwegian and 38% in the Swedish population. In the Norwegian population, hip dislocation was diagnosed in 18 children (15.1%; CI: 9.8 - 22.6) compared with only one child (0.7%; 95% CI: 0.01 - 4.0) in Southern Sweden (p = < 0.001). Hip surgery was performed in 53 (44.5%) of the Norwegian children and in 43 (32%) of the Swedish children (p = 0.03). The total number of hip operations was 65 in Norway and 63 in Sweden. Norwegian children were first operated at a mean age of 7.6 years (SD: 2.9) compared with 5.7 years (SD: 2.3) in Sweden (p = 0.001).</p> <p>Conclusions</p> <p>The surveillance programme reduced the number of hip dislocations and the proportion of children undergoing hip surgery was lower. However, with the surveillance programme the first operation was performed at a younger age. Our results strongly support the effectiveness of a specifically designed follow-up programme for the prevention of hip dislocation in children with CP.</p

DRD4 Polymorphism Moderates the Effect of Alcohol Consumption on Social Bonding

Development of interpersonal relationships is a fundamental human motivation, and behaviors facilitating social bonding are prized. Some individuals experience enhanced reward from alcohol in social contexts and may be at heightened risk for developing and maintaining problematic drinking. We employed a 3 (group beverage condition) ×2 (genotype) design (N = 422) to test the moderating influence of the dopamine D4 receptor gene (DRD4 VNTR) polymorphism on the effects of alcohol on social bonding. A significant gene x environment interaction showed that carriers of at least one copy of the 7-repeat allele reported higher social bonding in the alcohol, relative to placebo or control conditions, whereas alcohol did not affect ratings of 7-absent allele carriers. Carriers of the 7-repeat allele were especially sensitive to alcohol's effects on social bonding. These data converge with other recent gene-environment interaction findings implicating the DRD4 polymorphism in the development of alcohol use disorders, and results suggest a specific pathway by which social factors may increase risk for problematic drinking among 7-repeat carriers. More generally, our findings highlight the potential utility of employing transdisciplinary methods that integrate genetic methodologies, social psychology, and addiction theory to improve theories of alcohol use and abuse

Tectonically assisted emplacement of oceanic intraplate volcanoes: The Bathymetrists Seamounts, central Atlantic

The origin of broad intraplate volcanic provinces has been related to deep mantle plumes or shallow lithospheric processes, e.g., underlying large fault systems. One example of an understudied intraplate volcanic province is the Bathymetrists Seamounts (BSM) in the central-eastern Atlantic, an area with dense and extended fracture zones, but the BSM has been associated with a mantle plume origin. Extensive bathymetric mapping and seafloor sampling show that most BSM-seamounts resemble flat-topped guyots capped by carbonate platforms. Vesicular, volcanoclastic samples imply that their tops formed near sea level, followed by reef formation during cessation of volcanism and crustal subsidence. Erosion determines the seamount irregularity proportional to their sizes. Strong ellipticity of some seamounts is related to multiple vents that erupted along fractures. The orientation of the volcanoes, carbonate platforms, and morphological lineaments of the BSM show particular trends that reveal information on their origin and formation mechanisms. Geomorphological analyses indicate a structural control on volcano emplacement related to underlying lithospheric faults resembling a Riedel shear pattern. The stress field corresponding to their orientations is related to a NE-SW tensional setting, fitting to the prevalent tectonic setting ~56–38 Ma years ago that coincides with the BSM formation and an increase in spreading rates. A change in movement of the African plate during this time, together with the reactivation of fracture zones of the strongly sheared equatorial Atlantic, created pathways in the lithosphere and possibly enhanced magmatism. The seamounts do not show distinct differences in erosion state, morphology, carbonate platform depth, or Mn-crust thickness, in contrast to what would be expected for an age progression within the seamount chain. Our observations, therefore, do not support a plume mantle source. While the magmatic source remains undefined, we show that tectonic pathways determined the shape of the seamounts and enabled the broad emplacement of the Bathymetrists seamount chain